Alyse Marie Sullivan, NP is a medicare enrolled "Clinical Nurse Specialist - Women's Health" in Antioch, Tennessee. She graduated from nursing school in 2023 and has 2 years of diverse experience with area of expertise as Nurse Practitioner. She is a member of the group practice Community Medicine Foundation and her current practice location is
950 Brittany Park Dr Apt 423, Antioch, Tennessee. You can reach out to her office (for appointments etc.) via phone at
(530) 848-2648.
Alyse Marie Sullivan is licensed to practice in North Carolina (license number SULL-MEKDS) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1811777105.
Provider's Profile
| Full Name | Alyse Marie Sullivan |
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| Gender | Female |
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| Speciality | Nurse Practitioner |
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| Experience | 2 Years |
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| Location | 950 Brittany Park Dr Apt 423, Antioch, Tennessee |
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| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Alyse Marie Sullivan graduated from nursing school in 2023
NPI Data:
- NPI Number: 1811777105
- Provider Enumeration Date: 10/03/2023
- Last Update Date: 08/11/2025
Medicare PECOS Information:
- PECOS PAC ID: 2961841911
- Enrollment ID: I20240423004033
Medical Identifiers
Medical identifiers for Alyse Marie Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1811777105 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | 5022149 (North Carolina) | Secondary |
| 364SW0102X | Clinical Nurse Specialist - Women's Health | SULL-MEKDS (North Carolina) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|
| Community Medicine Foundation | 4880687490 | 11 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Alyse Marie Sullivan allows following entities to bill medicare on her behalf.
| Entity Name | Community Medicine Foundation |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1528004918
PECOS PAC ID: 4880687490
Enrollment ID: O20040407001159 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Alyse Marie Sullivan is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Alyse Marie Sullivan, NP
950 Brittany Park Dr Apt 423,
Antioch, TN 37013-5065
Ph: (530) 848-2648 | Alyse Marie Sullivan, NP
950 Brittany Park Dr Apt 423,
Antioch, TN 37013-5065
Ph: (530) 848-2648 |
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